Treatment Options for Dyspareunia Caused by Menopause

Menopause is the phase of life when women cease to be fertile, with estrogen and progesterone levels dropping and periods stopping all together. It typically occurs between a woman’s mid-forties to mid-fifties, with 51 being the average age. Some women may experience menopause sooner or slightly later than at this time. The hormonal changes occurring at this time can lead to some unpleasant or even painful symptoms. Some of the most common side effects of menopause include hot flashes, sweating, and difficulty sleeping.

One particularly unfortunate side effect of menopause can be dyspareunia, or pain during sexual intercourse. While dyspareunia can happen to anyone at any age for a variety of reasons, experts believe postmenopausal dyspareunia occurs due to hypoestrogenism, or a decrease in estrogen, and vaginal atrophy, which can lead to vaginal dryness; both vaginal atrophy and declining levels of estrogen are common in menopausal women. Symptoms of postmenopausal dyspareunia can range anywhere from mild to severe and can interfere with one’s personal life, both in private relationships and in other aspects of life, such as exercise and emotional distress. Many women may refuse to seek treatment due to embarrassment or lack of understanding of their symptoms and treatment options. Know that there are plenty of treatment options available, and that a healthcare professional can help patients decide which options might be best for their personal needs.

Intrarosa – Intrarosa is a 6.5 mg vaginal insert that does not have an FDA safety boxed warning and is the first FDA-approved drug containing prasterone. It is applied once daily and symptoms can alleviate in 12 weeks. Intrarosa typically costs around $200 for 28 6.5 mg inserts. Signing up for savings through Intrarosa’s site makes discounts available, with offers for eligible participants being $0 on the first prescription’s copay and up to $25 on subsequent copays for the first 12 uses.

Premarin – Premarin is available as both 1.) a low-dose vaginal estrogen cream that can ease pain experienced during intercourse after the first few weeks of starting treatment and 2.) conjugated estrogens tablets for reducing hot flashes. Like other similar creams, Premarin works by applying estrogen to rebuild vaginal tissue in order to reduce pain during sexual intercourse.

The cream can be applied biweekly or on a 28-day cycle (21 days on therapy, 7 days off); the average dosage is 0.5 g. The average cost is $350.11 per 30 g tube. By signing up for Premarin’s Vaginal Cream Pay As Little As $15 Co-pay Card program, participants can save up to $300 annually.

Imvexxy – Imvexxy is an applicator-free vaginal insert that the FDA recently approved for treating postmenopausal dyspareunia. The first two weeks its should be inserted on a daily basis, while every week after this it should be inserted only twice a week. It was designed to offer a treatment option for dyspareunia at a much lower dosage than other available options. Headaches are the most common side effect reported from Imvexxy use. The company has stated that it will be priced equivalent to other similar drugs available on the market.


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